Effects of unilateral arytenoid lateralization technique and suture tension on airway pressure in the larynx of canine cadavers

Abstract

To evaluate effects of the arytenoid lateralization technique and suture tension on airway pressure in the canine larynx. 7 canine cadaver larynges. Negative pressure was elicited aboral to the larynx. Airway pressure was measured at airflows of 15 to 120 L/min before and after thyroarytenoid lateralization (TAL), cricoarytenoid lateralization (CAL), and combined TAL and CAL (cricothyroarytenoid lateralization [CTAL]) at 100 and 500 g of suture tension and with sectioning of the sesamoid cartilage (SSC) and disarticulation of the cricothyroid joint (DCTJ). Rima glottidis area (RGA) was measured. Effects of technique, modification, and suture tension on pressure and RGA were evaluated statistically. Increased suture tension significantly reduced airway pressure for TAL at 30 L/min, CAL at 45 to 120 L/min, and CAL after SSC and DCTJ at 60, 75, and 105 to 120 L/min. The CAL and CTAL caused significantly lower airway pressures than did TAL > 30 L/min, but SSC and DCTJ did not significantly reduce pressure. All procedures, except TAL at 100 g of tension, resulted in a significant RGA increase from baseline. The CAL and CTAL caused a significantly greater RGA than did TAL. For TAL at 100 g of tension, SSC significantly increased RGA. CAL and CTAL caused lower airway pressures than did TAL. No significant pressure differences were detected between CAL and CTAL; SSC and DCTJ had little effect on pressure. Pressure may be a more sensitive indicator of airflow than is RGA in the larynx of canine cadavers.